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Analgesic efficacy of topical tramadol in the control of postoperative pain in children after tonsillectomy
(Springer Japan Kk, 2010) Akbay, Buket Kocaman; Yıldızbaş, Şahnur; Güçlü, Ender; Yılmaz, Süleyman; İskender, Abdülkadir; Öztürk, Özcan
Pain control after tonsillectomy is still a controversial issue. Topical approaches have the advantage of pain control with good patient acceptability. Therefore, this study was conducted to evaluate the effects of topical tramadol on postoperative pain and morbidity in children undergoing tonsillectomy. A prospective, randomized, double-blind, controlled clinical study was designed. Forty children aged between 4 and 15 years, ASA I-II, scheduled for elective tonsillectomy and/or adenoidectomy were randomized into two groups. For patients in Group T (n = 20) swabs soaked with 2 mg/kg tramadol diluted in 10 ml saline were applied to both of their tonsillar fossa for 5 min; in the control group (n = 20) swabs soaked with 10 ml saline were applied. Postoperative pain scores, bleeding, nausea, vomiting, abdominal discomfort, constipation, pain in the throat, painful swallowing, fever, otalgia, trismus, and halitosis were recorded at the first, fifth, thirteenth, seventeenth, twenty-first, and twenty-fourth postoperative hours and the week after tonsillectomy. Pain scores were found to be significantly lower at the 21st hour and on postoperative day seven in the tramadol group compared with the control group (p < 0.05). Mean daily pain scores ranged from Day 1: 0.34 (+/- 0.21) to Day 7: 0.11 (+/- 0.08) in the tramadol group and Day 1: 0.53 (+/- 0.14) to Day 7: 0.42 (+/- 0.15) in the control group. There were no significant differences in morbidity between the groups (p > 0.05). Topical 5% tramadol with its local anesthetic effect seems to be an easy, safe, and comfortable approach for pain management in children undergoing tonsillectomy.
Auditory evaluation in Parkinsonian patients
(Springer, 2009) Yılmaz, Süleyman; Karalı, Elif; Tokmak, Abdurrahman; Güçlü, Ender; Koçer, Abdulkadir; Öztürk, Özcan
Twenty Parkinson's disease (PD) patients (mean age 69.9 years) and 24 normal individuals' (mean age 63.8) both ears were investigated by brainstem auditory evoked potentials (BAEPs) and pure tone audiometry (PTA). There were no statistically significant age differences between the patients and control subjects. PTA results were significantly elevated for PD patients in 4,000 and 8,000 Hz (P < 0.05). Parkinsonian patients showed significantly increased latencies in wave V and I-V interpeak latencies (P < 0.05). The results of this study suggest that PTA and BAEPs could be affected in parkinson disease.
Baş Ve Boyun Tüberkülozları
(2012) Yaman, Hüseyin; Alkan, Nihal; Erdem, Havva; Aydın, Leyla Yılmaz; Yıldırım, Ümran; Güçlü, Ender
Amaç: Bu çalışmada baş boyun bölgesinde tüberküloz tanısı alan hastaların klinik ve tedavileri araştırıldı. Gereç ve Yöntem: Servikal tüberküloz lenfadenit ve baş boyunun diğer bölgelerinde tüberküloz tanısı alan 16 hastanın dosyaları retrospektif olarak incelendi. Hastaların yaş, cinsiyet, klinik, histopatolojik tanı ve tedavi protokolleri incelendi. Hastalara nodal eksizyon veya total eksizyon yapılmış olup tanıları histopatolojik inceleme sonucunda konulmuştur. Tüberküloz tanısı alan hastalar antitüberküloz tedavi protokolüne alınmıştır. Bulgular: Çalışmamız yaş aralığı 18 ile 72 yaş arasında değişen 16 hastayı [15 bayan (%93.75), 1 erkek (%6.25); ortalama yaş 43.614.7] içermektedir. Hastaların 13ünde (%81.25) tüberküloz lenfadenit, 1inde (%6.25) alt dudak tüberküloz, 1inde (%6.25) nazofarengeal tüberküloz, 1inde (%6.25) larengeal tüberküloz tespit edilmiştir. Antitüberküloz tedavi alan hastalarda tedavi sonucunda kitlelerin kaybolduğu gözlenmiştir. Sonuç: Baş boyun bölgesindeki kitlelerinin ayırıcı tanısında tüberküloz unutulmamalıdır. Baş boyunda genellikle tüberküloz lenfadenit şeklinde görülmekle birlikte nadirde olsa dudak, nazofarenks, larenks gibi bölgelerde de görülebilmektedir.
Branchio-ocuto-facial syndrome with the atresia of external ear
(Elsevier Ireland Ltd, 2005) Öztürk, Özcan; Tokmak, Abdurrahman; Demirci, Levent; Sılan, Fatma; Güçlü, Ender
We report an 8-year-old child with branchio-oculo-facial syndrome. He showed atresia of external ear, preauricular pit, maxillar and mandibular hypoplasia, mild ptosis on the left side, Lacrimal duct obstruction, unilateral branchial cyst, hypertrichosis of the neck, left foot showed mild syndactily of fourth and fifth toes and dental abnormalities. His mother had pseudocleft of the lip which Led to the diagnosis. The importance of serial observations in patients with rare genetic disorders is emphasized. (c) 2005 Elsevier Iretand Ltd. All rights reserved.
Burunda yabancı cisim: 130 hastanın değerlendirilmesi
(2015) Memişoğulları, Ramazan; İlhan, Ethem; Ulucanlı, Selim; Yaman, Hüseyin; Güçlü, Ender
Amaç: Bu çalışmada burunda yabancı cisim tanısı konulan hastaların klinik belirtileri ve tedavi protokolleri araştırıldı. Hastalar ve Yöntemler: Kasım 2008 - Temmuz 2013 tarihleri arasında burunda yabancı cisim tanısı konulan ve tedavisi yapılan 130 hasta (72 erkek, 58 kadın; ort. yaş 3.652.31 yıl; dağılım 15 ay-72 yıl) geriye dönük olarak değerlendirildi. Hastaların yaş ve cinsiyeti, yabancı cismin türü, hangi tarafta olduğu, belirti ve semptomları, tedavi uygulamaları ve sonuçları kaydedildi. Bulgular: Hastaların büyük bir çoğunluğu 2-5 yaş arasındaki çocuklardı (n113, %86.9). En fazla görülen yabancı cisimler; küçük plastik oyuncak parçaları (%43.8) fındık, ceviz, mısır ve fasulye gibi tohum taneleri (%29.2) idi. Hastaların 74ünde (%56.9) sağ, 54ünde (%41.6) sol nazal pasajda ve ikisinde (%1.5) ise her iki burun deliğinde yabancı cisim izlendi. Hastaların %92.3ü ilk 24 saat içerisinde kliniğimize başvurdu. Sonuç: Buruna yabancı cisim kaçması kulak burun boğaz hastalıkları acilinde sık karşılaşılan bir durumdur. Genellikle hayati bir risk oluşturmayan bu durum uzun dönemde çeşitli komplikasyonlara yol açabileceğinden acil müdahale gerektirir. Çocuk bakımından sorumlu ebeveyn ve bakıcılar buruna kaçabilecek cisimlerin çocukların ulaşabileceği yerlerde bulundurmamaları ve buruna yabancı cisim kaçması durumlarında hekime başvurmaları konusunda bilinçlendirilmelidir.
A case report of pneumosinus dilatans of the frontal sinus and review of the literature [Frontal sinüste pnömosinüs dilatans olgusu ve literatür taramasi]
(2010) Yılmaz, Süleyman; Akkan, Nermin; Yaman, Hüseyin; Güçlü, Ender; Yazıcı, Burhan
Pneumosinus dilatans is an extremely rare condition which is characterized by gross enlargement of the paranasal sinuses. The etiology is not identified. Pneumosinus dilatans refers to an aerated sinus which is abnormally expanded. Anatomical variations of the paranasal sinuses and nasal cavity are important in sinus diseases. We are reporting one patient with pneumosinus dilatans who attended Duzce medical faculty ENT department with severe headache. We considered as frontonasal complex and septum deviation disease by the CT and endoscopic examinations, and treated by functional endoscopic surgery and septoplasty surgery. Headache and nasal obstruction symptoms disappeared completely in the follow up period. Frontal sinus size is followed up by CT. Frontal sinus enlargement was seen with the preoperative paranasal CT which are taken consecutive years. Frontal sinus size reduction was evaluated 18 months after surgery with the control paranasal sinus CT examination. © 2010 Düzce Medical Journal.
Congenital unilateral intranasal membranous septa with choanal atresia dividing the nasal cavity into two blind pouch: A case report
(Elsevier Ireland Ltd, 2010) Yılmaz, Süleyman; Güçlü, Ender; Karalı, Elif; Subaşı, Buğra
Congenital nasal anomalies are rare disorders. An 11-year-old girl presented to our clinic with a left sided nasal obstruction and chronic nasal discharge since birth. Clinical evaluation revealed membranous septa which divided the left nasal cavity into two blind pouch and left sided choanal atresia with alar cartilage asymmetry. This congenital anomaly was not defined in the English literature. The membranous septa in the left nasal cavity were excised, alar reconstruction were performed and the choanal atresia were repaired by a transnasal endoscopic approach. In this article we reported a case of membranous septa which divided the left nasal cavity into two blind pouch associated with unilateral choanal atresia and alar cartilage asymmetry. Also the nasal anomalies and associated disorders in the literature were reviewed. © 2009 Elsevier Ireland Ltd. All rights reserved.
Does pregnancy-associated plasma protein A have a role in allergic rhinitis?
(Ocean Side Publications Inc, 2008) Güçlü, Ender; Coşkun, Abdurrahman; Tokmak, Abdurrahman; Duran, Sadık; Öztürk, Özcan; Akkan, Nermin; Egeli, Erol
Background: Pregnancy-associated plasma protein A (PAPP-A), also known as insulin-like growth factor binding protein 4 protease, is postulated to be a new inflammatory marker in various clinical situations such as cardiovascular events, dialysis, renal transplantation, and asthma. PAPP-A also is produced in high concentrations by trophoblasts during pregnancy. Methods: We evaluated PAPP-A levels in allergic rhinitis patients and compared these with levels in healthy subjects. Thirty-one newly diagnosed allergic rhinitis patients and 29 healthy controls were included in the study. Serum PAPP-A, IgE, urea, creatinine, aspartate aminotransferase, creatine kinase (CK), CK-MB isoenzyme, total cholesterol, and triglyceride levels were determined. Results: The serum PAPP-A level was significantly higher (p = 0.013) in the allergic rhinitis group (6.1 +/- 2.9 mU/L) than in the control group (4.5 +/- 1.7 mU/L). The PAPP-A level in patients with allergic rhinitis and asthma (6.1 +/- 2.3 mU/L) was not significantly different (p = 0.959) from that in patients with allergic rhinitis alone (6.1 +/- 3.3 mU/L). The serum PAPP-A level in allergic rhinitis patients who had turbinate hypertrophy (6.9 +/- 2.2 mU/L) had a tendency to be higher than that in patients who had no turbinate hypertrophy (5.5 +/- 3.2 mU/L); however, this difference was not statistically significant (p = 0.151). Conclusion: Increased PAPP-A activity may be involved in the inflammation and tissue remodelling that occurs in allergic rhinitis.
Does topical lidocaine with adrenaline have an effect on morbidity in pediatric tonsillectomy?
(2005) Egeli, Erol; Harputluoğlu, Uğur; Oğhan, Fatih; Demiraran, Yavuz; Güçlü, Ender; Öztürk, Özcan
Objective: To evaluate the efficacy of lidocaine with adrenaline on post-operative morbidity in pediatric patients after tonsillectomy. Study Design: A double blind prospective randomized controlled clinical study. Methods: The study is consisting of two groups of pediatric patients following tonsillectomy performed in a university hospital. One group received lidocaine with adrenaline soaked swabs packed in their tonsillar fossae while the control group received saline-soaked swabs. Chi-square and two-tailed unpaired Student's t-tests were used to compare the two independent groups. p < 0.05 was accepted as statistically significant. Results: No significant pain-relieving effect was seen in the lidocaine with adrenaline group (p > 0.05) and also the other post-operative parameters such as nausea, fever, vomiting, odor, bleeding, otalgia and trismus were not statistically different between the two groups based on chi-square analysis (p > 0.05). There were no complications associated with lidocaine and adrenaline. Conclusion: We suggest that application of topical lidocaine with adrenaline seems to be a safe and easy medication for local anesthetic use. However, in our study, lidocaine with adrenaline offered no advantage over placebo in the control of post-operative pain and other morbidity related factors following pediatric tonsillectomy. We therefore do not recommend topical application of lidocaine with adrenaline for reducing morbidity in pediatric tonsil surgery. © 2005 Elsevier Ireland Ltd. All rights reserved.
Does topical ropivacaine reduce the posttonsillectomy morbidity in pediatric patients?
(Elsevier Ireland Ltd, 2008) Oğhan, Fatih; Harputluoğlu, Uğur; Güçlü, Ender; Kocaman, Buket; Öztürk, Özcan
Objectives: To determine whether post-operative administration of topical ropivacaine hydrochloride decreases morbidity following adenotonsillectomy. Study Design: Prospective, randomized, double-blind clinical trial. Setting: University referral center; ENT Department. Participants: Fourty one children, aged 4-16 years, undergoing tonsillectomy. Methods: Patients received 1.0% ropivacaine hydrochloride soaked swabs packed in their tonsillar fossae while the control group received saline-soaked swabs. Mc Grath's face scale was used to compare the two groups in respect of pain control. Chi-square and two-tailed unpaired Student's t-tests or Mann-Whitney-U-tests were used to compare the two independent groups. As 10 we made 11 comparision between groups, for Bonferroni correction, p < 0.005 was accepted as statistically significant. Results: Only first hour there was no significant pain-relieving effect seen in the ropivacaine group (p > 0.05). The other hours and days there were statistically significance between the two groups (p < 0.001). Also, the other post-operative parameters such as nausea, fever, vomiting, odor, bleeding, otalgia and trismus were not statistically different between the two groups. There were no complications associated with ropivacaine hydrochloride. No patients in this study suffered systemic side effects related to the use of this medication. Conclusion: Locally 1.0% ropivacaine administiration significantly relieves the pain of pediatric tonsillectomy and, it is a safe and effective method. High concentrations of ropivaciane may produce clinically significant pain relief. It is more effective to reduce of post-operative analgesic requirement after first hour. (c) 2007 Elsevier Ireland Ltd. All rights reserved.
The effect of duration of nasal obstruction on mean platelet volume in patients with marked nasal septal deviation
(Springer, 2016) Ünlü, İlhan; Kesici, Gülin Gökçen; Öneç, Birgül; Yaman, Hüseyin; Güçlü, Ender
Nasal obstruction is a common cause of marked nasal septal deviation. It is related strongly with hypoxia. Hypoxic conditions increase mean platelet volume levels. This study aimed to investigate the effect of age on mean platelet volume in patients with marked nasal septal deviation. We made a retrospective study of patients with marked nasal septal deviation between January 2012 and May 2014. The patients were divided into four groups according to duration of nasal obstruction (less than 10, 10-20, 20-30 and more than 30 years). The groups were compared with each other in terms of mean platelet volume, platelet distribution width, platelet count in preoperative hemogram. This study was performed on 356 male and 139 female patients. Mean age was 33.9 +/- A 12.3 years. It was determined that the platelet count, mean platelet volume did not constitute statistically significant difference between groups (p > 0.05). Nevertheless, it was determined that as the duration of nasal obstruction elongated the mean platelet volume value increased and platelet count values decreased. Mean values of platelet distribution width constituted statistically significant difference between all groups (p = 0.026). Patients with marked nasal septum deviation should be subjected to surgery as soon as possible because of the increase in mean platelet volume and platelet distribution width values which are related to increase in the risk of cardiopulmonary complications of nasal obstruction.
Effects of desflurane on middle ear pressure
(Elsevier Ireland Ltd, 2007) Öztürk, Özcan; İlçe, Zekeriya; Demiraran, Yavuz; İskender, Abdülkadir; Güçlü, Ender; Yıldızbaş, Şahnur
Objective: To evaluate the effects of desflurane on middle ear pressure. Study design: A prospective clinical study. Methods: In this study, 38 ears of 19 mate childrens that were scheduled for circumcision were included. Baseline tympanometry reading was performed on each ear just before anesthesia. After induction anesthesia with propofol a laryngeal mask was applied and desflurane administration was started. The next tympanometry reading was taken at 5th, 10th and 15th minute after administration and at the 10th minute after the cessation of desflurane. Data were analysed using Wilcoxon test. Results: Mean MEP values before anesthesia in 38 ears of 19 boys were -10.32 +/- 33.14. After starting the administration of desflurane 5th minute mean value was 71.15 +/- 60.42, at the 10th minute 111.56 +/- 59.03 and at the 15th minute it increased to 120.50 +/- 54.14, and these measurements were significantly higher than the starting value (p < 0.001). After cessation of desflurane mean MEP value dropped to 57.56 +/- 79.06, but compared with the starting value this was also significantly higher (p < 0.001). Conclusion: Desflurane may increase the middle ear pressure and it may be unsuitable for certain middle ear surgeries. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
Effects of sevoflurane and TIVA with propofol on middle ear pressure
(Elsevier Ireland Ltd, 2006) Öztürk, Özcan; Demiraran, Yavuz; İlçe, Zekeriya; Akbay, Buket Kocaman; Güçlü, Ender; Karaman, Emin
Objective: To evaluate the effects of sevoflurane and TIVA with propofol on middle ear pressure and to show the importance of anesthesia without using any inhalational agents during middle ear surgery. Study design: A prospective, randomized controlled clinical study. Methods: In this study, 25 male children that were scheduled for circumcision were randomised into two groups. Group I (n = 13) received TIVA with propofol and group II (n = 12) received sevoflurane. Baseline tympanometry reading was performed on each ear just before anesthesia. The next tympanometry reading was taken 10 min after applying the laryngeal mask. Data were analysed by Mann-Whitney U (between groups) and Wilcoxon tests (within groups). Results: Mean MEP values in 26 ears of 13 boys in group I did not show any significant difference before and after the anesthesia with propofol (p > 0.05). In group II mean MEP values in 24 ears of 12 boys showed a significant increase after the anesthesia with sevoflurane (p < 0.001). No significant difference was found between the MEP values of the two groups before the anesthesia (p > 0.05), and MEP values measured during the anesthesia were significantly higher in group II (p = 0.007). Conclusion: Sevoflurane may increase the middle ear pressure and TIVA with propofol may be used in middle ear operations more safely than sevoflurane. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
The effects of topical levobupivacaine on morbidity in pediatric tonsillectomy patients
(Elsevier Ireland Ltd, 2009) Yılmaz, Süleyman; Demiraran, Yavuz; Akkan, Nermin; Yaman, Hüseyin; İskender, Abdülkadir; Güçlü, Ender; Öztürk, Özcan
Objective: To reduce the post-tonsillectomy morbidity by swab soaked with 5 ml levobupivacaine hydroclorur (25 mg/10 ml). Study design: A double-blind prospective randomized controlled clinical study. Methods: In this randomized double-blind study in group I (30 children, mean age 7.5 +/- 2.6) we tightly packed swab soaked with 5 ml levobupivacaine hydroclorur (25 mg/10 ml) and in group II (21 children, mean age 7.9 +/- 3.7) we used 5 ml saline swabs into each of the two tonsillar fossae after tonsillectomy for 5 min. We used McGrath's face scale to compare the two groups in respect of pain control. Results: There was statistically significant pain relieving effect in the levobupivacaine group in the first 24 h (p < 0.05). But after 24 h pain relieving effect of levobupivacaine was not significant (p > 0.05). We did not see any serious complications for both groups. Postoperative morbidity mean results (nausea, vomiting, fever, bleeding, halitosis and ear pain) were not statistically different between the two groups (P > 0.05). Conclusion: Topical levobupivacaine seems to be a safe and easy medication for postoperative pain control in pediatric tonsillectomy patients. (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Efficacy of Topical Levobupivacaine in Control of Postoperative Pain after Septoplasty
(Bmc, 2010) Yılmaz, Süleyman; Akbay, Buket Kocaman; Yıldızbaş, Şahnur; Güçlü, Ender; Yaman, Hüseyin; Sezen, Gülbin Yalçın
Objective: To search the efficacy of using Merocele (Medtronic, Minneapolis, MN) soaked with 5 mL of levobupivacaine hydrocloride as a nasal pack in control of postoperative pain after septoplasty. Design: The study was designed as a prospective, double-blind, randomized, controlled study. Forty-one patients who underwent septoplasty operation were included in the analysis. Setting: A tertiary referral hospital in Turkey. Material and Methods: Forty-one patients undergoing septoplasty were divided into two groups. At the end of the operation, Merocele packs were placed inside the nasal cavity. In the levobupivacaine group, each Merocele pack was soaked with 5 mL of levobupivacaine hydrochloride (25 mg/10 mL), and in the control group, Merocele packs were soaked with 5 mL of saline. Main Outcome Measures: Postoperative pain levels were recorded using a visual analogue scale (VAS score, 0-100) at 30 minutes and 1, 2, 8, 12, and 24 hours. Results: We did not find any significant difference between groups regarding age, gender, American Society of Anesthesiologists status, and body mass index. Postoperative VAS values at 30 minutes and 1, 2, 8, and 12 hours were significantly lower in the levobupivacaine group compared with the control group (p < .05). The need for supplemental analgesia was significantly lower in the levobupivacaine group compared with the control group (p < .01) Conclusion: Postoperative pain after septoplasty owing to nasal packing is an important problem, and using levobupivacaine-soaked Merocele as a nasal pack after septoplasty is an effective method for the control of this pain. It is a very easy, effective, and quick method and it improves patient comfort after septoplasty.
Esthesioneuroblastoma with Unusual Metastasis to T10 Vertebra: Case Report and Review of the Literature
(Düzce Üniversitesi, 2011) Karalı, Elif; Güçlü, Ender; Öztürk, Özcan; Yıldırım, Ümran; Yılmaz, Süleyman
Esthesioneuroblastoma is a rare malignant tumor orginating from the olfactory epithelium. A52–year-old man admitted to our clinic with a 3 months history of progressive nasal obstruction,epistaxis and mass on the nasal radix. On rhinoscopy, a polypoid mass was seen in the bothnasal cavity and we performed an intranasal biopsy with local anesthesia. On histopathologicanalysis the tumor was identifed as an esthesioneuroblastoma. The tumor was classified asKadish stage B. The mass was excised via bilateral endoscopic endonasal resection and lateralrhinotomy approach. Radiotherapy was performed postoperatively. During the follow up,submandibuler lymph node metastasis occured ten months after surgery. The patient underwentbilateral type III modified radical neck dissection followed by radiotherapy to the neck. Distantmetastasis developed on the T 10 vertebra 12 months after the initial treatment. Although hehad distant metastasis he was free of local recurrence 13 th month after surgery. In conclusionbecause of locoregional recurrences are common in esthesioneuroblastomas, patients must befollowed carefully but also we have to remember that distant metastasis may appear withoutlocal recurrence
Esthesioneuroblastoma with unusual metastasis to T10 vertebra: case report and review of the literature
(2011) Yılmaz, Süleyman; Karalı, Elif; Güçlü, Ender; Öztürk, Özcan; Yıldırım, Ümran
Estezyonöroblastom olfaktuar epitelden köken alan nadir görülen malign bir tümördür. 52 yaşındaki erkek hasta kliniğimize 3 aydır devam eden ilerleyici burun tıkanıklığı, burun kanaması ve nazal radikste kitle ile başvurdu. Rinoskopik muayenede her iki nazal kavitede polipoid kitle görüldü ve lokal anestezi ile biyopsi yapıldı. Histopatolojik analiz sonucunda estezyonöroblastom tanısı konuldu. Tümör Kadish evre B olarak değerlendirildi. Endoskopik endonazal ve lateral rinotomi ile yaklaşımları ile kitle eksizyonu yapıldı. Postoperatif radyoterapi uygulandı. Takiplerinde cerrahiden 10 ay sonra submandibuler lenf nodu metastazı saptandı ve hastaya bilateral tip 3 modifiye radikal boyun diseksiyonu yapıldı ve sonrasında radyoterapi uygulandı. Cerrahiden 12 ay sonra ise T10 vertebrada uzak metastaz saptandı. Hastanın uzak metastazı olduğu halde primer bölgede rekürrens saptanmadı. Sonuç olarak estezyonöroblastomalarda lokal nüksler sık olduğu için hastaların dikkatli bir şekilde takip edilmeleri gereklidir ve aynı zamanda lokal rekürrens olmadan da uzak metastaz olabileceği de akılda tutulmalıdır.
Evaluation and Management of Antrochoanal Polyps
(Korean Soc Otorhinolaryngol, 2010) Yaman, Hüseyin; Yılmaz, Süleyman; Karalı, Elif; Güçlü, Ender; Öztürk, Özcan
Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the maxillary anti-urn and they extend into the choana. They occur more commonly in children and young adults, and they are almost always unilateral. The etiopatho-genesis of ACPs is not clear. Nasal obstruction and nasal drainage are the most common presenting symptoms. The differential diagnosis should include the causes of unilateral nasal obstruction. Nasal endoscopy and computed tomography scans are the main diagnostic techniques, and the treatment of ACPs is always surgical. Functional endoscopic sinus surgery (FESS) and powered instrumentation during FESS for complete removal of ACPs are extremely safe and effective procedures. Physicians should focus on detecting the exact origin and extent of the polyp to prevent recurrence.
Evaluation of middle ear pressure in the early period after adenoidectomy in children with adenoid hypertrophy without otitis media with effusion
(W B Saunders Co-Elsevier Inc, 2015) Ünlü, İlhan; Ünlü, Elif Nisa; Kesici, Gülin Gökçen; Güçlü, Ender; Yaman, Hüseyin; İlhan, Ethem; Memiş, Mehmet
Objective: Our aim was to analyze the changes in middle ear pressure in the early period after adenoidectomy in children with adenoid hypertrophy without otitis media with effusion. Methods: This prospective, descriptive study was performed on 64 patients (with normal tympanic membranes and tympanograms) undergoing adenoidectomy or adenotonsillectomy. All patients were operated by single experienced team using curettage technique. First tympanometry was done on the day before surgery. Tympanometry was repeated on the first-, third-, and seventh-day after the operation. Patients are separated into two groups according to age as patients younger than 6 years (Group A) and patients older than 6 years (Group B). All data were separately evaluated for each ear using Jerger Classification. Results: Of the 64 patients included in the study, 35 were male and 29 were female, and the average age was 91.01 +/- 37.4 (35-178) months. Pathological decreases in the middle ear pressures of at least one ear were determined in 48 (75%) patients on the first postoperative day and in 10 (15.6%) patients on the third postoperative day. Middle ear pressures returned to preoperative values by the seventh postoperative day except in two patients. There were statistically significant differences (p <0.0001) among preoperative and first, third, and seventh postoperative day mean middle ear pressure. There were no statistically significant differences between Groups A and B in terms of tympanometry values of both ears obtained preoperatively and on the first, third, and seventh postoperative day. Conclusion: In our study, temporary eustachian dysfunction and aural fullness occur in the early period after adenoidectomy and/or adenotonsillectomy. This situation may be due to post-surgery clots and edema in nasopharynx. We consider that tubal orifice can be exposed to surgical trauma as adenoidectomy surgeries are done by curettage technique. There is a need for comparative studies using microdebrider or laser adenoidectomy accompanied by an endoscope. (C) 2015 Elsevier Inc. All rights reserved.
Frontal sinüste pnömosinüs dilatans olgusu ve literatür taraması
(2010) Yılmaz, Süleyman; Akkan, Nermin; Yaman, Hüseyin; Güçlü, Ender; Yazıcı, Burhan
Pnömosinüs dilatans nadir görülen, etyolojisi tam olarak bilinmeyen paranazal sinüslerin içinde sadece hava bulunan ve normal epitelyum ile döşenmiş anormal genişlemesi ile karakterize bir bulgudur. Paranasal sinüslerdeki ve septumdaki anatomik varyasyonlar sinüs hastalıklarında önemli yer tutmaktadır. Zaman zaman oluşan şiddetli baş ağrısı ve burun tıkanıklığı yakınmasıyla DTF KBB Anabilim Dalı'na müracaat eden olguya yapılan incelemeler sonucu pnömosinüs dilatans tanısı konuldu. Endoskopik muayene ve bilgisayarlı tomografilerinde, frontonasal kompleks ve septum patolojisi saptanan olguya endoskopik cerrahi ve septoplasti cerrahisi uygulandı. Postoperatif izleme döneminde baş ağrısı ve burun tıkanıklığı semptomlarının tamamen kaybolduğu gözlendi. Hastanın frontal sinüs genişliği paranasal BT ile takip edildi. Preoperatif bir yıl arayla çekilen paranasal BT ‘lerinde frontal sinüs genişliğinde artış saptanan hastanın postoperatif 18 ay sonra çekilen kontrol paranasal BT sonucunda frontal sinüs genişliğinde azalma saptanmıştır.

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